Report on the Performance of the Activities of the National Preventive Mechanism for 2019
As not all the sanitary facilities in the Osijek PU and the Rab PH have been segregated by sex, all the
patients must perform their personal hygiene tasks in the same bathrooms.
A problem common to all psychiatric institutions is the inadequate protection of the patients' right
to spend time outdoors, especially those who have physical, not only mental, disorders, and are thus
less mobile. For this reason, terraces and ground-level yards urgently have to be put in order, by
installing overhead covering and the necessary amenities to allow even the most severely ill patients
to spend time in fresh air. In addition, we also pointed out the need to reduce overcrowding,
especially in one of the Osijek PU departments, where four women live in a small room, and whose
privacy is thus fully compromised, while such conditions can also foster a negative atmosphere in
their therapies.
The 2008 Report of the Special Rapporteur on torture and other cruel, inhuman or degrading
treatment or punishment makes it clear that poor conditions in psychiatric institutions and care
homes for persons with disabilities represent degrading treatment under article 3 of the ECHR. This
is also confirmed by ECtHR case-law, in the
Romanov v Russia case (2005), where the
Court confirmed that the applicant was held
in a secure unit of a psychiatric institution for
one year, three months and 13 days, some
four and a half months of which were spent
in a small, overcrowded room. In the judicial
proceedings
it
was
established
A problem common to all psychiatric
institutions is the inadequate protection of
the patients' right to spend time outdoors,
especially those who have physical, not only
mental, disorders, and are thus less mobile.
that
prolonged confinement in a secure-type unit combined with poor accommodation conditions
represented degrading treatment. Therefore, although the existence of an intention to do so was
not established, the Court found that the standards of accommodation have demeaned the
applicant's human dignity and caused him to feel humiliation and degradation.
From interviews and focus groups with persons with mental disorders conducted during our visits,
as well as from complaints we received, we observed that patients, even those who have been
committed voluntarily, are not always adequately informed as to why they are held there and what
is going to happen to them. Some have indicated that while they did formally agree to
hospitalisation, they gave their consent in fear of forced detention or placement, that is, in fear of a
court order. They are frequently unacquainted with their treatment plans, do not know which
therapies they are on, they ask whether they can go home or out for a walk and do not know why
they are denied this, or wonder why they are in a secure unit even though they have been voluntarily
committed.
Due to the importance of informed consent, which is a legal obligation, but also a chance to create
trust and partnership in treatment, we organised a roundtable with a number of stakeholders, in
order to try to identify and understand the problems and act to prevent them. Although we observed
that there has been significant progress in informing the patients about their rights through leaflets,
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